Why does the HSE continue hiring such bad doctors?

Among the many disturbing findings from the Medical Council inquiry into the conduct of Dr Andrea Hermann, perhaps the most shocking was the revelation that she did not tell those interviewing her at Sligo University Hospital that she had previously been sanctioned by the Medical Council.

This is the latest in a litany of incidents in which a doctor’s background was apparently not adequately investigated by the HSE before they were hired.

In January, another doctor, Omar Hassan, was found guilty of poor professional performance and professional misconduct. He worked in Portlaoise for six months, and then in Mayo General and Galway University Hospital.

During the unsuccessful appeal by Dr Hassan, who once mistook an ankle for an elbow in an X-ray, the president of the High Court, Mr Justice Peter Kelly, expressed concern about how he had obtained positions at three different hospitals.

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The then minister, Leo Varadkar, called on the HSE to review its recruitment policies.

The HSE is the biggest employer in the State, with more than 100,000 staff. Its national recruitment service claims it has a “suite of checks” including reference checks, occupational health clearance, Garda clearance and validation of medical registration and related documentation. The Medical Council also stipulates that a certificate of current professional status must be filed to establish that potential applicants are “in good standing, with no ongoing proceedings, conditions or findings against [them]”.

Despite this, Dr Hermann was given a job and allowed to practise for almost a year at Sligo University Hospital even though she had had findings of professional misconduct of “the most serious category” found against her three years previously, in June 2010, by the Medical Council.

They related to three cases . One involved a mother of two, Saundra O’Connor who, at the age of 39, had been under Dr Hermann’s care at the Galway Clinic for a routine gynaecological operation. Following this procedure in 2005, O’Connor developed an infection which led to multiple organ failure, cardiac arrest and severe brain damage. She was in a semi-vegetative state for three years and died in 2008 as a direct result of those complications.

Suspended from practice

At the fitness-to-practise committee hearing in 2010, Dr Hermann admitted that, in O’Connor’s case, inadequate investigations were carried out; appropriate antibiotics were not administered at the right time; there was a failure to seek the opinion of a surgical colleague; and a failure to apply appropriate standards of judgment in respect of the care given.

Dr Hermann was suspended from practice for one year and for three years after that ordered to work in a post under the supervision of a named consultant acceptable to the Medical Council.

At this month’s inquiry into allegations of poor professional performance involving six patients at Sligo between July 2013 and May 2014, it was alleged by the hospital that Dr Hermann did not tell personnel in July 2013, during an interview, that conditions had been attached to her ability to practise following a period of suspension by the Medical Council. Dr Hermann claims she did tell the hospital but the Medical Council found she had failed to disclose to the Sligo hospital authorities the conditions imposed on her as a result of the previous disciplinary hearing.

During this month’s inquiry, a consultant in Sligo said that in June 2013 Dr Hermann told an interview team (including that consultant) that she had no conditions attached to her continued practice. This consultant told the inquiry that she was aware of some media reports about Dr Hermann and her previous history with the Medical Council, but she was not aware of many details at that time. The interview lasted for at least 30 minutes, and was attended by a number of hospital staff.

Before working in Sligo, Dr Hermann had also come to the attention of the authorities in the UK. In January 2012, the fitness-to-practise panel of the Medical Practitioners Tribunal in the UK found that Dr Hermann had failed to notify the General Medical Council about the Irish Medical Council’s 2010 findings, a failure that amounted to misconduct. Conditional registration was imposed as a sanction. This UK finding was publicly available information in 2013.

Duty to patients

The public at large and patients need to be satisfied that stringent checks are carried out in the hiring of doctors by hospital authorities. The questions need to be asked: how is it that a doctor who has findings of misconduct against her in two different jurisdictions can be hired by a leading teaching hospital in one of our major cities?

Is it satisfactory that an employer who has an awareness of some issues does not delve deeper into those? How is it that Dr Hassan and Dr Hermann were hired by the HSE without, it seems, adequate background checks being done? Repeatedly in the case of Dr Hassan.

And these are not the only two cases. In August 2016, the Medical Council found a third doctor guilty of professional misconduct because he did not disclose the fact that he had been refused registration in the UK.

Should such an approach be tolerated in any work environment, let alone the medical profession, where lives are at stake, and the consequences of errors can be so grave? Until these questions have been answered to a satisfactory standard, how can we have confidence in the recruitment policies of those to whom we entrust our wellbeing, our health and our lives?

Roger Murray is a solicitor and acted for the family of the late Saundra O'Connor. He is advising some of the patients involved in the most recent inquiry